Background: Ketogenic very low energy diets (VLED) providing 1,900-3,340 kJ (450-800 kcal) and 50-80 g of carbohydrate per day are recognised clinically for promoting weight loss with concomitant appetite suppression in overweight and obese adults. However, this level of carbohydrate restriction excludes many nutrient-rich foods from the diet, notably dairy, fruit and some vegetables. It is not known the extent to which dietary carbohydrate intake must be restricted in order to achieve appetite suppression. We aimed to determine whether a moderately low carbohydrate diet (104 g per day) results in appetite suppression during weight loss.
Methods: In this clinical trial (NCT02030249), 70 overweight and obese pre-diabetic men and women, 25-70 years of age with a body mass index (BMI) ≥ 25 kg/m2, received a moderately low carbohydrate (104 g per day), low energy diet (3,390 kJ or 810 kcal per day) for 8 weeks. The low energy dietary formulation was supplemented with 3-4 servings of skim milk and 300 g of non-starchy vegetables per day. Body weight and fasting appetite (measured using visual analogue scales) were determined at baseline (week 0) and at week 8. Changes between baseline and week 8 were compared using repeated measures ANOVA, adjusting for baseline scores.
Results: Mean body weight was significantly reduced by the 8-week intervention (-11.6 ± 2.5 kg, p < 0.001). At week 8, fasting hunger was significantly decreased compared to baseline (-8.3 ± 3.2 mm, p < 0.05), and fasting scores for desire to eat, prospective food consumption and fullness were unchanged from baseline.
Conclusions: A moderately low carbohydrate low energy diet providing 104 g carbohydrate per day, rich in low fat dairy, does not preclude the hunger suppression that has been reported for ketogenic VLEDs that provide only 50-80 g carbohydrate per day.